Utility for Uncorrected Refractive Errors in Adolescent Schoolchildren in Kakamega County, Kenya

Abstract

SIGNIFICANCE Uncorrected refractive errors (UREs) present an enormous lifetime burden in children. Despite this, there is a dearth of knowledge on URE-related preference-based quality of life (QoL) in East Africa. This study demonstrates the positive impact of interventions on UREs; hence, it provides an empirical justification for advocacy to improve the QoL of children with URE. PURPOSE This study investigated the preference-based QoL (utility) for URE in school-going adolescents of Kakamega County, in Kenya. METHODS An observational cross-sectional study with multistage sampling was conducted on randomly selected secondary school adolescents. School-going adolescents in Forms 1 to 4 were clinically examined for the presence of URE and classified according to their URE types. Pre-screened students who met the selection criteria were classified into two groups: URE and normal sight. Participants in the normal-sight group were randomly selected from among screened students without URE. Selected participants were administered a previously validated adolescent-specific utility weighting instrument—Assessment of Quality of Life—Six Dimensions. RESULTS A total of 330 participants aged 17.32 ± 1.60 years (URE, 17.50 ± 1.58 years; normal-sight, 17.15 ± 1.61 years) were included in the study. The mean utility score, as elicited by the Assessment of Quality of Life—Six Dimensions scoring algorithm, was better in the normal-sight group (URE, 0.496 ± 0.22; normal sight, 0.567 ± 0.25) at baseline, whereas the reverse was true at follow-up (URE, 0.655 ± 0.20; normal sight, 0.603 ± 0.25). In all cases, the differences were significant (P < .05); however, there was no significantly better (P > .05) utility elicited by any URE subtype at any given time point. Nonetheless, the URE group showed significantly better utility (P < .05) after spectacle correction. CONCLUSIONS Uncorrected refractive errors are associated with reduced utility in school-going adolescents, regardless of URE subtype. Spectacle correction resulted in a significantly improved utility for those with URE. Thus, this study recommends early public health strategies and spectacle interventions in schools for adolescents with URE.